How to use the Joint Formulary

The Joint Formulary is broken down into chapters, based upon the categories used in the British National Formulary (BNF). It comprises a list of drugs recommended in each section. Each drug is colour-coded in a traffic-light system to facilitate prescribing choice. For more details on the Joint Formulary traffic light system, please see the drop down list below below.

The prescriber should always ensure they have the expertise to prescribe an agent before making a selection. In its guidelines on responsibility for prescribing between hospitals and general practitioners, the Department of Health has advised that legal responsibility for prescribing lies with the doctor who signs the prescription.

Introduction Joint Formulary Traffic Light System

Green - Non-Specialist Drugs

Suitable for non-specialist initiation.

Blue - Specialist Initiation WITHOUT Shared Care Guidelines

For drugs that do not require specific monitoring or where the monitoring is on-going by the specialist. The drugs are recommended or initiated by a specialist and GPs continue to prescribe on specialist advice without the need for a formal shared care guideline but a shared care information sheet setting out responsibilities may be available. A minimum of one month's supply of medication will be provided by the consultant if initiating. Information on the initiation process and whether a shared care information sheet will be supplied will be detailed on the Joint Formulary.

Amber - Specialist Initiation WITH Shared Care Guidelines

For drugs which require specialist initiation and/or dose titration and specific ongoing monitoring. For initiation, dose stabilisation and prescribing (including monitoring) by a specialist until the patient is stabilised (usually for a minimum 3 months but see individual shared care protocols) after which the GP can be asked to agree shared care through the use of shared care guidelines. Primary care will be expected to undertake some specific monitoring under shared care.

Red - Specialist ONLY drugs

For initiation and continuation (including monitoring) by a specialist only. A specialist is not necessarily a consultant, rather a practitioner with specialist skills e.g. specialist registrar, nurse specialist, GP with specialist interest, community psychiatric nurse, tissue viability nurse.

Black - Not routinely supported

Drugs that have been considered by the APC and are not routinely supported for initiation in any health setting for NHS patients.